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Anti-Kickback Statute

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Getting paid for remote and virtual care services: CPT codes to know and understand

Getting paid for remote and virtual care services: CPT codes to know and understand

Until November, reimbursement for remote patient monitoring services was a…

Health and Human Services wants to end 'middlemen kickbacks' in drug pricing by targeting rebates

Health and Human Services wants to end 'middlemen kickbacks' in drug pricing by targeting rebates

Under the proposal, drugs would be chosen that have the lowest…

Whitepapers

The Evolution of Utilization Review and Its Impact on Revenue Integrity

The Evolution of Utilization Review and Its Impact on Revenue Integrity

Existing utilization review (UR) paradigms are no longer suitable for addressing the…

Taking Value Analysis to the Next Level

Taking Value Analysis to the Next Level

In the industry's ongoing transition from fee-for-service to value-based, healthcare executives are being challenged to…

News

Analyze this: Health systems, health plans get to the core of big data

Analyze this: Health systems, health plans get to the core of big data

Pamela Peele knows that people who subscribe to cooking magazines have a much higher risk of going to the emergency room. But how she knows that is a whole other story.

Once-failing hospitals say accountability, transparency key to surviving fallout from failing patient safety grades

Once-failing hospitals say accountability, transparency key to surviving fallout from failing patient safety grades

When Leapfrog released their Spring 2016 patient safety grades recently, 15 hospitals got slapped with a very public 'F' grade casting a spotlight on them that no institution wants. But with more patients weighing public hospital grades, experts, as well as a few…

Healthcare mergers and acquisitions in 2016: Running list

Healthcare mergers and acquisitions in 2016: Running list

While 2015 was a record-breaking year in healthcare mergers and acquisitions, 2016 saw more change as organizations across the industry adjust and adapt to the evolving financial landscape.

Whitepapers

Gaining Actionable Insight into Financial Systems and Areas Impacting the Revenue Cycle

Gaining Actionable Insight into Financial Systems and Areas Impacting the Revenue Cycle

Hospital systems across the country are looking to streamline their billing and collection processes to become more efficient and better compete in their markets. The challenge many face is how to turn the data that's already flowing through financial systems into…

Credible, Defensible Estimates

Credible, Defensible Estimates

In healthcare, every interaction with the patient matters. Especially in today’s environment of continuous improvement, efforts have been concentrated on coordination among providers, the patient care experience and quality outcomes – all laudable goals.

Clinical Quality Measures 101

Clinical Quality Measures 101

Although quality-reporting programs such as meaningful use provide incentives to help providers implement and use electronic health records (EHRs) to collect and report on clinical data, practices often need help deciding what data to collect, which measures to…